What causes pericoronitis?
By Tom Seymour
Reviewed by Judith Marcin, MD
Pericoronitis occurs when the wisdom teeth do not have enough room to erupt through the gums. As a result, they may only partially come through the gum, which may lead to inflammation and infection of the soft tissue around the wisdom tooth.
If wisdom teeth only partially erupt, gum flaps may develop. These flaps are areas where food can become trapped, and bacteria can build up, causing infection.
Fast facts on pericoronitis:
- Wisdom teeth normally come through during late adolescence.
- Pericoronitis can be either short-term (acute) or long-term (chronic).
- Pericoronitis usually develops in people over 20 and under 40 years old.
The symptoms can vary between individuals depending on the severity of the infection.
Chronic symptoms include:
- dull pain
- mild discomfort
- bad taste in the mouth
- swollen gum in the affected area
Chronic symptoms often only last for 1 to 2 days but keep recurring over a period of months.
Acute symptoms usually last 3 to 4 days and can include:
- severe pain that can cause loss of sleep
- swelling on the affected side of the face
- discharge of pus
- pain when swallowing
- swollen lymph nodes under the chin
What are the causes?
Pericoronitis commonly occurs in people in their 20s, with around 81 percent of those affected being aged between 20 and 29 years old.
Men and women develop pericoronitis in equal numbers.
There are also some common causes and conditions associated with pericoronitis:
- poor oral hygiene — this more commonly causes acute pericoronitis
- upper respiratory tract infection — this is caused by a virus — often a cold — or bacteria, and affects the nose, sinuses, and throat
Dentists often diagnose pericoronitis during a clinical evaluation. The dentist will diagnose the condition by examining the wisdom teeth and checking for signs and the appearance of pericoronitis.
The dentist will look to see if the gums are inflamed, red, swollen, or draining pus. They will also look to see if there is a gum flap in the affected area.
The dentist might also take an X-ray to look at the alignment of the wisdom teeth and to rule out other possible causes for the pain, such as dental decay.
If a doctor diagnoses pericoronitis, they will refer the individual to a dentist for further treatment.
What are the treatment options?
Once the dentist has diagnosed pericoronitis, they will design a treatment plan according to the specific needs of the individual.
The condition can be difficult to treat because if there is a gum flap, then the problem will not go away completely until the tooth fully erupts, or the tooth or tissue is removed.
If the person has symptoms that are localized to the area around the tooth then the dentist may try the following treatment options:
- thoroughly cleaning the area
- removing any food debris
- draining any pus
If there is an infection, then the dentist will prescribe antibiotics, and an individual can take other medication to manage the pain and reduce swelling. A person should consult their dentist before using any over-the-counter medications or mouth rinses.
In many cases, the dentist may recommend removing the tooth, especially if it is a recurring problem.
It is vitally important that symptoms of pericoronitis are treated swiftly to keep the infection from spreading and to lessen the risks of complications.
Anyone experiencing symptoms of pericoronitis should contact their dentist as soon as possible. Those who realize their wisdom teeth are coming through but have no symptoms of pericoronitis should still tell their dentist so that they can monitor the progress.
For minor cases of pericoronitis, some home remedies can help alleviate and treat symptoms.
A warm saltwater rinse can help, as can cleaning the affected area carefully with a toothbrush to remove plaque and food debris.
However, if a person sees no improvement after 5 days, then they should consult a dentist.
It is not recommended to use home remedies if a person is experiencing severe symptoms.
Complications associated with pericoronitis can occur. Problems are more likely to happen if the symptoms are not treated promptly.
Sometimes, the infection can spread from the affected area, which can lead to swelling and pain in other parts of the head and neck.
Trismus, where a person finds it difficult to open their mouth or bite down, can also be a complication.
In rare cases, complications of pericoronitis can even be life-threatening. Untreated pericoronitis can lead to Ludwig’s angina, which is an infection that spreads under the jaw and tongue. This condition can also cause other deep infections within the head, neck, or throat.
There is also the possibility that the infection can spread into the bloodstream, in a condition known as sepsis, which can also be life-threatening.
Steps that people can take to try and reduce the chance of pericoronitis developing include:
- Good oral hygiene: Extra cleaning around the affected tooth to remove food debris and bacteria will help.
- Regular visits to the dentist: Regular check ups will help the dentist identify any signs or problems associated with pericoronitis, increasing the chance of treating them early.
- Taking pre-emptive action: Contacting the dentist whenever a person has any concerns about pericoronitis developing is recommended.
Typically, pericoronitis causes no long-term effects. If the wisdom tooth fully erupts or is removed then pericoronitis will not reoccur in that area.
If a tooth is removed, then a person can usually expect to make a full recovery after about 2 weeks.
During recovery, a person can expect to experience:
- jaw stiffness
- a mildly bad taste in the mouth
- tingling or numbness of the mouth and face (less common)
Following all aftercare instructions is essential. A person should contact their dentist or oral surgeon if they experience intense or throbbing pain, fever, or bleeding.
The most important thing about treating pericoronitis is ensuring that individuals receive the right treatment so that this painful condition can be corrected as soon as possible.
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